妊娠期阴道毛滴虫病的筛查与诊治  

Screening and diagnosis and treatment of trichomonas vaginalis during pregnancy

作　　者：张岱[1] ZHANG Dai(Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院,北京100034

出　　处：《中国实用妇科与产科杂志》2021年第10期1005-1007,共3页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家自然科学基金面上项目(81971342)。

摘　　要：阴道毛滴虫病是常见的阴道感染和性传播感染,主要症状为分泌物异常,无症状患者多。常用检测方法为湿片法,但有一定漏诊率,高度怀疑阴道毛滴虫感染而湿片法阴性时可选用核酸方法帮助诊断。妊娠期阴道毛滴虫感染患者早产风险增高,新生儿垂直传播少见,新生儿感染主要为泌尿系感染以及肺部感染。有症状的妊娠期阴道毛滴虫感染患者推荐积极检测和治疗,治疗方法可首选甲硝唑2g顿服疗法。一般认为甲硝唑在妊娠期间使用是安全的。对于妊娠期间无症状阴道毛滴虫感染的治疗意见尚不一致。一项多中心研究认为无症状妊娠期阴道毛滴虫感染使用甲硝唑干预治疗会增加早产的发生率,目前妊娠期无症状患者不推荐筛查阴道毛滴虫,除非患者存在早产高危因素。Trichomonas vaginalis is a common vaginal infection and sexually transmitted infection.The main symptom is abnormal secretion,and there are many asymptomatic patients.The common test method is wet film method,but there is a certain rate of missed diagnosis.The patients highly suspected with Trichomonas vaginalis infection but with negative wet film can be examined by nucleic acid method to help diagnosis.Patients with Trichomonas vaginalis infection during pregnancy are at increased risk of preterm birth;neonatal vertical transmission is rare,and neonatal infections are mainly urinary tract infections and lung infections.Symptomatic patients with Trichomonas vaginalis infection during pregnancy are recommended to be actively tested and treated,with Metronidazole 2 g as the first choice for treatment.Metronidazole is generally considered safe to use during pregnancy.There is no consensus on the treatment of asymptomatic Trichomonas vaginalis infections during pregnancy.A multicenter study has found that the use of metronidazole as an intervention for asymptomatic Trichomonas vaginalis infection increases the risk of preterm birth.Currently asymptomatic pregnant patients are not recommended for Trichomonas vaginalis screening,unless the patient has a risk factor for preterm labor.

关 键 词：妊娠 阴道毛滴虫病 筛查 诊断 治疗 

分 类 号：R711.73[医药卫生—妇产科学]